Chatterjee Nilesh, Gupte Himanshu, Mandal Gauri, Bhutia Tshering
Salaam Bombay Foundation, Mumbai, India.
Narotam Sekhsaria Foundation, Mumbai, India.
Tob Prev Cessat. 2019 Nov 26;5:45. doi: 10.18332/tpc/113355. eCollection 2019.
This study aimed to test whether school-going adolescents who self-report tobacco and/or supari use are more likely to quit if a school-based psychosocial cessation intervention is added to an existing life-skills and tobacco-prevention program.
A quasi-experimental trial with pre-test and post-test 20 weeks after the intervention was conducted with students from low-income families in 12 schools in Mumbai; six schools were randomly assigned to the intervention and the remaining to the comparison condition. Participants were students from grades 7, 8 and 9 who self-reported tobacco and/or supari use. Intervention schools received six sessions of LifeFirst, a psychosocial group-based tobacco cessation intervention program, in addition to SuperArmy, a school-wide life-skills and tobacco-prevention program. Trained counselors facilitated the cessation intervention, which spanned five months. All students in comparison schools received only SuperArmy. The outcome measures were self-reported use of tobacco-only, supari-only, and tobacco plus supari in the past 30 days.
The number of all users decreased by 19.1% in the intervention and 18.7% in the comparison schools at post-test. Although this reduction was significant (p<0.001) within each group, the difference between intervention and comparison schools was not significant. Further segregation by type of product used showed that for tobacco-only users there was a non-significant increase of 1.7% in intervention schools, and a significant 26.2% increase (p<0.001) in the comparison group. Tobacco plus supari use declined in both groups; however, supari-only use fell by 14.8% in the intervention and 32.7% in the comparison schools (p<0.01).
The combination of a cessation intervention along with the life-skills and tobacco-prevention program appear to have halted tobacco-only use in the intervention group. Future research needs to determine whether students are substituting supari for tobacco and to understand the psychological mechanisms underlying the cessation intervention and the interaction between cessation and prevention-only interventions.
本研究旨在测试，对于自我报告有烟草和/或槟榔使用情况的在校青少年，如果在现有的生活技能和烟草预防项目基础上增加一项基于学校的心理社会戒烟干预措施，他们是否更有可能戒烟。
在孟买12所学校对低收入家庭的学生进行了一项干预前和干预后20周进行测试的准实验性试验；6所学校被随机分配到干预组，其余学校为对照组。参与者为7、8、9年级自我报告有烟草和/或槟榔使用情况的学生。干预学校除了接受全校范围的生活技能和烟草预防项目“超级军队”外，还接受了六节“生命优先”课程，这是一个基于心理社会的团体戒烟干预项目。由经过培训的咨询师推动进行为期五个月的戒烟干预。对照组的所有学生只接受“超级军队”项目。结果指标为自我报告的过去30天内仅使用烟草、仅使用槟榔以及同时使用烟草和槟榔的情况。
干预后测试时，干预组所有使用者数量减少了19.1%，对照组减少了18.7%。虽然每组内这种减少具有显著性（p<0.001），但干预学校和对照学校之间的差异不显著。按所使用产品类型进一步细分显示，对于仅使用烟草的使用者，干预学校有1.7%的不显著增加，而对照组有26.2%的显著增加（p<0.001）。两组中烟草加槟榔的使用都有所下降；然而，仅使用槟榔的情况在干预学校下降了14.8%，在对照学校下降了32.7%（p<0.01）。
戒烟干预措施与生活技能和烟草预防项目相结合似乎在干预组中阻止了仅使用烟草的情况。未来的研究需要确定学生是否用槟榔替代了烟草，并了解戒烟干预的心理机制以及戒烟干预与仅预防干预之间的相互作用。
